



LIBRARY OF CONGRESS. 

Chap»......rcopyriglit No. 

ShelfJl53- 



UNITED STATES OF AMERICA. 



8681 ^g 190 



A MANUAL OF 



Osteopathic Therapeutics 



— BY- 

CLIFFORD E> HENRY, Ph.G.,M. D..D.0. 

PROF. OF ANATOMY AND OSTEOPATHIC THERAPEUTICS 
IN NORTHERN INSTITUTE OF OSTEOPATHY; EX- 
PRESIDENT of the FACULTY and PROFESSOR 
OF ANATOMY and OSTEOPATHIC THER- 
APEUTICS IN PACIFIC SCHOOL 
OF OSTEOPATHY. 



/ 

Published by 
THE AUTHOR 

MINNEAPOLIS 

1898 






18357 



To MY WIFE 

THIS SMALL WORK IS AFFECTIONATELY DEDICATED AS AN 
ACKNOWLEDGMENT OF THE ENCOURAGEMENT AND ASSIST- 
ANCE EXTENDED IN ITS COMPLETION. 

— BY — 

THE AUTHOR. 



Copyright 1898 

By C. E. HENRY 

All Rights Reserved 




2nd copy 

1898. - 



PREFACE 



In presenting this small volume to the public, I 
have been careful to make it as concise as possible, 
and yet, at the same time; cover the principal points. 
In the classification of the osteopathic movements, 
as first suggested by myself, I feel that I have helped 
in the advancement of the science. I do not give 
the technique of the osteopathic movement, there- 
fore the book is not one that anyone can pick up, 
learn, and then feel competent to go out into prac- 
tice. I have confined myself to explaining the 
physiological actions of the movements by illus- 
trating the case in point by a typical case. It 
would take a volume many times larger than this 
to consider each disease separately. It makes no 
difference what you call the disease, you must recog- 
nize the physical condition of your patient, and then 
understanding the physiological A<*r1toN of your 
"movements, use them accordingly, I have intended 
this book as a text-book while in college and a ref- 
erence book when in practice. 

Clifford E. Henry. 



CONTENT© 



Introduction — 

Principles of Osteopathy. 

Disease. 

Pathology. 

Symptomatology. 

Morbid Anatomy. 

Histology. 

Etiology. 

Contagious and Infectious Diseases. 

Secondary Diseases. 

Predisposing Causes. 

The Clinical History. 

Period of Incubation. 

Prodromes. 

Termination. 

Diagnosis. 

Prognosis. 

Treatment. 

Modes of Action. 

Dosage. 

Idiosyncrasies. 

Duration of Action. 

Indications and Contra Indications. 

Combination of Movements for Joint Effects. 

Incompatibility. 



Classification of Movements as to Physiological Action 
Abortifacients. 
Alteratives. 
Anaesthetics. 

Aphrodesiacs and Anaphrodesiacs. 
Anti-Emetics. 
Anti-Pyretics. 
Anti-Arthritics. 
Anti-Spasmotics. 
Bitters, or Gastric Stimulants. 
Cardiac Stimulants. 
Cardiac Depressants. 
Cathartics. 
Cholagogues. 
Diaphoretics. 
Diuretics. 
Emetics. 
Emmenagogues. 
Expectorants. 
Hypnotics. 
Mydriatics. 
Nervous Sedatives. 
Nervous Stimulants. 
Tonics. 

Uterine Stimulants. 
Uterine Depressants. 
Vaso-Motor Stimulants. 
Vaso-Motor Depressant. 



Nerve 



Reflex 



1st Cervical ) 



2d 
3d 
4th 



I- 



5th " 
6th " 
7th " 
1st Thoracic 



2d 
3d 
4th 

5th 
6th 

7th 

8th 

9th 

10th 

11th 

12th " 

1st Lumbar J 



2d 

3d 

4th 

5th 

1st Sacral 



2d 
3d 
4th 
6th " 

Coccyx 



1- 



1 



J 



Back part of Scalp and Neck 



Scapular, 



Thorax 



Epigastric. 



Abdominal. 



Cremasteric. 
Knee-Joint. 

Gluteal. 



y Back of Thigh, Leg and Foot. 



y Buttocks. 



OSTEOPATHIC THERAPEUTICS. 



Introduction. 

The Principles of Osteopathy: — Are based upon 
a thorough knowledge of what are termed the ele- 
mentary branches, — that is, anatomy and physiol- 
ogy. To understand these thoroughly, the founda- 
tion is laid for a line of argument, as to the causes 
of disease, formed upon a purely mechanical basfs. 

Disease: — Is a word used to express some de- 
parture from the normal. The etymology of the 
word is very interesting. Dis, a noun from the 
Latin, represents a Roman myth, a name some- 
times given to Pluto, the Roman equivalent of the 
Greek Hades, hence, infernal regions. Dis, a prefix, 
meaning apart, or asunder. Ease is defined as a 
state of the mind or body free from pain or dis- 
comfort of any kind. The disease is: Organic, 
when involving any organic change in the affected 
parts : Functional, when the abnormal phenomena 
are independent of any apparent structural lesion. 

Pathology: — Is -the study of the morbid condi- 
tions which are produced by disease, and explains 
their origin, cause, history and nature. Special 



12 MANUAL OF OSTEOPATHIC THERAPEUTICS. 

Pathologi is the study of the morbid conditions of 
individual diseases. General Pathology is the study 
of the morbid conditions common to a number of 
diseases. 

> .mptomo-;' :j: , — The branch of pathology, the 
object of which is the observation and knowledge 
of the signs and symptoms of disease. Symptoms 
are divided into subjective, or those known only to 
the patient : hose which are evident to the 

examining physician. 

Mc Irid A ': : . — Is the change which takes 
place in diseased structure, and is appreciable by 
the e ::hout the use of the raicroscc 

Histology : — Is the study of the minute anatomy 
of a healthy body. This is of the greatest impor- 
tance, to an osteopath, for oftentimes the cause of 

the disturbance of function will be found U be 
within the structure of the same organ. 

Et — Treats of the cause of disease. The 

cause, from an osteopathic standpoint, may be 
summed up as a departure from normal of some 
tissue or tissues, thereby interfering with the per- 
fect action of the human mechanism. The cause 
may be external, but affecting an internal organ, as. 



MANUAL OF OSTEOPATHIC THERAPEUTICS. 13 

for example, contraction of a muscle, from cold, 
and this, in turn, pressing on an underlying nerve 
or blood vessel, thereby cutting off the nerve force 
or the nutrition to an internal organ. Or, it may be 
of internal origin, and the parts affected be exter- 
nal, as, for example, the dislocation of a bone, press- 
ing on a nerve, going to the periphera. In this way 
we may have the exciting point some distance from 
the point of the disease. 

Contagious and Infectious Diseases : — Are those 
due to the deposit of a specific germ in the tissue, 
but from an osteopathic standpoint there must be 
a suitable soil for these germs to grow or else they 
would be destroyed. 

The leucocytes are the destroyers of germs, and 
the blood in perfect condition is able to overcome 
an ordinary attack of any germ. 

Secondary Diseases : — Are those arising second- 
ary to some primary trouble, as, for example, pleu- 
risy, from pneumonia, or uraemic coma, from kidney 
disease. 

Predisposing Causes : — Are causes which tend 
to give a special liberty or susceptibility to certain 
diseases. They may be inherited or acquired. 



14 



MANUAL OF OSTEOPATHIC THERAPEUTICS. 



Inherited when born of parents who labor with 

« 

disease, as, for example, a child born of consump- 
tive parents has a greater tendency to become con- 
sumptive. 

Acquired from age, habits, occupation, sex and 
race : (Modified from Hughes.) 

Children to catarrhal disorders. 

Young adults, to fevers. 

Age: I Middle age, to heart, kidney, liver and gas- 

tric troubles, 

Old age, general degenerative changes. 



Habits. 



I 



Nervousness due, to alcoholism. 

Perverted sexual ideas, 

General nervous strain, due to nervous dis- 
ease. 



Miners. 
Cutters. 
Occupation. Painters. 
Printers. 
Weavers. 



Sex. 



Women, nervous diseases. 
Men, rheumatism, pneumonia. 



Race. 



Negro, phthisis and scrofula. 

Jews, diabetes and exopthalmic goitre. 



MANUAL OF OSTEOPATHIC THERAPEUTICS. 15 

The Clinical History: — Is the history of the dis- 
ease thioughout its entire course, including the 
period of incubation, to the termination. 

Period of Incubation: — Is the time elapsing in an 
infectious or contagious disease from the time the 
bacilli gain a point of infection and the appearance 
of the symptoms. 

Prodromes: — Are the earliest symptoms recog- 
nized, as, for example, the alternating hot and cold 
spells before an attack of fever. 

Termination : — If by a cure, the termination is 
of three forms: (1) lysis, slow return to health; 
(2) crisis, abrupt termination of disease; (3) met- 
astasis, changing from one location to another. 

The acute disease may be followed by second- 
ary processes ; that is, when the first disease is sub- 
stituted by a second, as, for example, the heart 
trouble which follows rheumatism. 

The termination may be death. The four forms 
of death are: (1) anaemia, a lack of quantity or 
quality of blood ; (2) apnoea, non-areation of the 
blood; (3) asthenia, gradual loss of vital power; 
(4) coma, a deep sleep, from which they can with 
difficulty be aroused. The brain is the first organ 
affected. 



16 MANUAL OF OSTEOPATHIC THERAPEUTICS. 

Diagnosis : — The naming of a disease implies a 
perfect understanding of the case. The osteopath 
must always look for the cause, and until he is able 
to demonstrate or give a clear reason for naming 
the disease, he should not consider that he ha& 
made a diagnosis. 

A diagnosis may be made direct when the mor- 
bid condition is revealed, or when he is able to 
demonstrate that which is the cause. 

A differential diagnosis is made when the excit- 
ing point may be in such a position as to be the 
cause of symptoms common to a number of dis- 
eases, and the diagnosis is made by eliminating 
one from the other. 

Diagnosis by exclusion is made by proving the 
absence of all diseases which might give rise to 
symptoms common with the one under discussion, 
but this is uncertain, as there is no positive symp- 
tom upon which to rely. 

Prognosis : — Is the fore-telling the termination 
of a disease, and should be given with a great 
amount of caution, as it involves a knowledge only 
acquired by long experience. 

Treatment :— This is the most important point 
of consideration after the diagnosis has been made 



MANUAL OF OSTEOPATHIC THERAPEUTICS, 11 

and the disease is believed to be amenable to oste- 
opathic treatment. Treatment does not consist en- 
tirely in the use of osteopathic manipulations, but 
the hygiene and diet must be looked after, for the 
ultimate end aimed at is to cure, relieve, or prevent 
disease. Bathing, out-door exercise and proper 
wearing of the clothing, in some nervous diseases, 
are the principal means of cure, while in some gas- 
tric troubles the simple regulation of the diet, pre- 
venting over eating, the eating of improper foods, 
and at improper hours, will bring about the re- 
quired result. 

The aim of on osteopath is to remove the cause 
of disease. In some cases this is an impossibility, 
and, in such cases, the system is put in the best con- 
dition possible for relief, as, for example, cardiac 
disease. This may be of such a nature the osteo- 
path can not cure it, yet improve the circulation to 
such an extent the patient will live in comparative 
comfort the rest of his days. 

Modes of Action: — There are two methods by 
which the treatment affects the body, near or direct 
or remote or indirect In the direct treatment, the 
effect is on the structures, in the immediate vicin- 
ity, as for example, a case of synovitis of the knee r 



18 MANUAL OF OSTEOPATHIC THERAPEUTICS. 

the treatment would be confined, principally, to the 
knee and contingent structures. 

In the indirect method the treatment is given at 
one place for correction of a diseased condition in 
a distant part, as, for example, pressure upon the 
nerves of the back for pain in the thigh ; or, when 
the action is still more remote from the place of 
treatment, a stimulation of one of the cerebro-spi- 
nal nerves is transmitted to the sympathetic, as, 
for example, stimulation of Auerbach's and Meiss- 
ner's flexus is obtained by this method. 

Another interpretation of the indirect treatment 
is the general good health that very often follows a 
course of treatment. No apparent change being 
noticed during the course of treatment, but an im- 
provement soon after the treatment ceases — a reflex 
action, so to speak. 

Modes of Administering Treatment: — Without 
the least possibility of doubt, the best method of 
administering a treatment is upon the nude skin. 
The fingers have firmer hold. The secret, in touch, 
is a firm, even, regular touch, The fingers should 
not glide over the surface, but move the tissue be- 
neath them, and when the patient has the body cov- 
ered this is sometimes difficult, especially if she 



MANUAL OF OSTEOPATHIC THERAPEUTICS. 19 

brings a horse blanket wrapper for a treatment 
gown. 

Another objection to having a covering over the 
body is that very often there are irregularities or 
eruptions not prominent enough to be distinguished 
through clothing, but which have a very important 
bearing on the case in question. 

The body should, in no case, be unnecessarily 
exposed. I have frequently recommended to my 
female patients that they open the back of the 
treatmant gown and place buttons on it the same as 
the front. With this kind of a garment the patient 
derives all the benefit of treatment on the nude, 
and has not the unpleasantness of exposure. 

Electricity or hydrotherapy may be used as a 
general stimulant along the spine in a very large, 
unwieldy patient. The electricity, unless applied 
by an experienced hand, is very liable to do a great 
amount of damage. In hydrotherapy the use of 
the needle spray as a stimulant up and down the 
spine has been demonstrated to be of decided ad- 
vantage in cases of beginning locomotor ataxia. 

Dosage: — The dosage of osteopathic treatment 
should be studied as carefully as the regular studies 
the dose of his drugs. Common sense is as much 



20 MANUAL OF OSTEOPATHIC THERAPEUTICS. 

in demand in giving an osteopathic treatment as 
the regular should use in writing a prescription. 
No one would think of giving a frail, delicate per- 
son the same treatment one would give a big, robust 
person. But a big, robust person can not always 
take a heavy treatment, and, therefore, the patient 
must be studied carefully in all cases, and the 
treatment given accordingly. 

In the treatment of chronic cases, give chronic 
case doses ; that is, a treatment about every other 
day will be sufficient. In acute cases,, the effect of 
your first treatment must be carefully watched and 
then a treatment given at regular intervals. The 
medical man knows just how long the effect of the 
drug he prescribes will last, and prescribes another 
dose to be administered just as the effects of the 
former are waning. In osteopathic treatment of 
acute cases, the same method of administration 
should be used. 

Idiosyncrasies: — Some people are not made 
like other people, and they have peculiarities that 
must be respected. As, for example, a case came 
under the attention of the author who could bear 
no pressure on the neck. There was no pathologi- 
cal lesion to be detected, but pressure there caused, 



MANUAL OF OSTEOPATHIC THERAPEUTICS. 21 

immediately, a throbbing headache that ceased im- 
mediately the pressure was released. Where a case 
of this character presents itself for treatment, it 
would be doing the patient a very grave injustice 
to not consider it, but treat it as a whim. 

Some of the conditions governing these idio- 
syncrasies are: (1) climate, people of warm cli- 
mates being more frequently the subject of them; 

(2) temperament, people of a nervous temperament ; 

(3) the female sex; and (4) the aged. 

Indications and Contra-Indications: — The indi- 
cation for osteopathic treatment is any symptom, 
or series of symptoms, which we know the treat- 
ment will relieve, without, at the same time, caus- 
ing an evil effect to be felt in other parts of the 
body. A contra-indication is any co-existing state 
or tendency which will be made so much worse 
by the treatment as to forbid its use. 

Combination of Movements for Joint Effects: — 
When an osteopath examines a case and determines 
the cause, he sould also determine upon a line of 
treatment. For example, the person comes to the 
office complaining of headache, and the pain is 
found to be due to some derangement of the diges- 
tive tract. There is no need of giving that patient 



22 MANUAL OF OSTEOPATHIC THERAPEUTICS. 

a general treatment, putting him through the paces 
of everything one knows. Give him a prescription, 
and let that prescription consist only of the move- 
ments necessary for the cure of the disease. By 
the joining together of a number of movements, a 
chain is formed, and the physiological action 
greatly increased. 

Incompatability : — Care must be taken, however, 
in making up the prescription that one movement 
does not kill the effects of another. For example, 
it would be folly to stimulate a nerve at one point 
and depress it at another, or depress at the point 
one expected the reflex. An operator could go 
over a patient, giving him, seemingly, a very thor- 
ough treatment, and yet so kill each movement that 
the patient would not receive any benefit. 



MANUAL OF OSTEOPATHIC THERAPEUTICS. 23 



CLASSIFICATION OF MOVEMENTS AS TO 
PHYSIOLOGICAL ACTION. 

Abortifacients and Oxytoxics. 

The operator should use the greatest of care in 
inducing a premature labor, not only from a moral 
standpoint, but with regard to the mother's life. 

The treatment here given is intended more for 
the aid of child birth at term than for the induction 
of premature birth. For the child to leave the 
uterus, the door must be opened for it or it remains 
a prisoner. 

The clitoris is analogous to the penis of the 
male and has the same nerve distribution. Passing 
down on each side of the clitoris are the genital 
branches of the genito crural distributed over the 
labia and the internal pudic to dorsum of clitoris. 
Pressure on each side of this organ causes a stimu- 
lation of these nerves and an impulse is sent to the 
partuition centre of the cord situated in the anterior 
horns of the gray matter of the cord in the lumbar 
region. Stimulation of the sensory side of these 
nerves causes a reflex action to take place, the im- 
pulse is switched to the motor side and through the 



24 MANUAL OF OSTEOPATHIC THERAPEUTICS. 

rami communicantes the impulse is transmitted to 
the sympathetic system. The function of the sym- 
pathetic system is to produce peristaltic action, 
therefore when the uterine division of the hypogas- 
tric plexus is stimulated, a peristaltic wave starts 
throughout the uterus that first dilates the cervix; 
then expels whatever body the uterus contains. 

Pressure made upon the first and second lumbar 
nerves after the head is well started through the os, 
does not inhibit the motor nerves, for the centre is 
in the anterior roots, as before stated, and there is 
sufficient stimulation in the hypogastric plexus to 
expel the child. Pressure here though does prevent 
the sensory impulses reaching the brain and there- 
fore the labor is not only greatly shortened in time, 
by the rapid dilation of the os but the pain is les- 
sened to a considerable extent. 

If an abortion is desired, the stimulation of the 
nerves of the clitoris should be about every four 
hours and the pressure continued from five to ten 
minutes at a time. This explains why there are so 
many miscarriages during the first years of mar- 
riage, the excessive cohabitation produces too much 
stimulation of the clitoral nerves. 



manual of osteopathic therapeutics. 25 

Alteratives. 

An alterative treatment is one which gradually 
induces a change and restores healthy functions 
without sensible evacuations. This is the general 
treatment used in the correction of long standing 
pathological conditions. For example; a patient 
presents himself for examination and treatment, 
and upon examining the skin an eruption is found. 
No special lesion can be found, but there is some- 
thing wrong in a number of places. The treatment 
takes the nature of a general treatment to alter the 
pathological condition and thereby change the 
morbid condition into a healthy one. 

Anaesthetics. 

An anaesthetic treatment is one which produces 
an insensibility or numbness of pain. Local anaes- 
thesia is the only method used in osteopathic man- 
ipulations. General anaesthesia is where the entire 
body is affected, as the giving of chloroform or 
ether in surgical operations. Pressure upon a nerve 
-causes a desensitization of the area of distribution 
of that nerve, it is local in that it is confined, but 
general in that the area effected may be the entire 
limb or arm. 



26 manual of osteopathic therapeutics. 

Aphrodesiacs and Anaphrodesiacs. 
Aphrodesiacs are treatments given to increase 
the sexual power, and an anaphrodesiac is one 
given to allay sexual excitement. A patient pre- 
sents himself and gives the history that he is unable 
to produce an erection, or the erection is very feeble 
and relaxation takes place very soon, or the case 
may be that he has a perfect erection but ejacula- 
tion takes place immediately upon entrance or 
before entrance. The penis is made erect by the 
blood being retained in the sinuses of the corpora 
cavernosum and corpora spongiosum by the con- 
traction of the erector penis against the pubis. The 
dorsal nerves of the penis are the affarent nerves of 
this reflex unless the stimulation originates by an 
impulse from the brain. The genito crural and in- 
ternal pudic bring the impulse to the aphrodesiaa 
centre in the anterior horns of gray matter of cord 
in the lumbar region. The efferent nerve is the 
nervi erigentes causing dilatation of the sinouses 
and contraction of the erector penis. Therefore in 
a case in which the erection is imperfect the treat- 
ment is stimulation of the upper lumbar and lower 
dorsal region. In a case of priapism however, ana- 
phrodesiac action is required, therefore the treat- 
ment is to desensitize these nerves. 



MANUAL OF OSTEOPATHIC THERAPEUTICS. 27 

In cases in which the erection is perfect but 
ejaculation is premature the affarent nerves are the 
dorsal nerves of penis, and the efferent nerves, the 
cerebro spinal nerves emerging through the fourth 
and fifth lumbar intervertebral foramina, fibers of 
these nerves connecting with the hypo-gastric plexus 
which sends branches to the vas deferens and vesi- 
culi seminalies. Stimulation of the lumbar region 
will generally effect a cure but as a rule it takes from 
three to six months treatment. For undue sexual 
excitement, the patient should be examined for a 
hood bound clitoris or irritating growths. Smegma 
accumulates underneath the hood and as there is no 
way for it to escape it becomes rancid and causes 
an irritation and a constant desire for cohabitation. 
This constant reflex stimulation of the uterus is the 
cause of many girls being nervous, hysterical or 
delicate and who would become healthy if the hood 
could be loosened. 

Anti-Emetics. 

Anti-emetics are treatments given to prevent 
nausea and vomiting. Vomiting is the result of 
some irritation of the gastric nerves, causing a re- 
gurgitation to take place. The muscles of the 



28 MANUAL OF OSTEOPATHIC THERAPEUTICS. 

stomach, assisted by the diaphram and abdominal 
muscles, expel the food from the stomach and it is 
ejected by the mouth. 

Vomiting is, at times, sympathetic, as in affec- 
tions of the uterus, kidney, brain, etc., or sympto- 
matic, as in gastritis, peritonitis, etc. The stimu- 
lus may be a direct stimulation of the centre of 
vomiting, in the medulla, by tumor growths, local 
disease, from the blood, as in fevers, from poisons 
or drugs. Or the stimulus may be reflex, from the 
viscera. 

The treatment is to desensitize the nerves from 
the fourth to the sixth thoracic vertebrae. The 
great splanchnic takes its origin from this area, and 
helps form the solar plexus. Through rami com- 
municants, it connects with the cerebro-spinal 
nerves. Therefore, when pressure is made at these 
points the impulse is inhibited in its course. The 
best method is to cause the scapula to become 
prominent by bringing the arm around behind, on 
the back, then make the pressure under the edge of 
the scapula. Nausea is commonly termed sick 
stomach, and yields to the same treatment. 



manual of osteopathic therapeutics. 29 

Anti-Pyretics. 

A treatment for the lowering of body tempera- 
ture, either by heat radiation or heat dissipation, is 
termed an anti-pyretic or febrifuge. Fever is a rise 
in bodily temperature, characterized by marked tis- 
sue change, disordered functions and an increased 
circulation. The primary cause of fever is a dis- 
turbance of the nervous system, supposed to be 
those nervous centers adjacent to the corpus stria- 
tum, which, by experiments, have been found ta 
control the production and dissipation of heat. 
This disturbance may be brought about by stimu- 
lation of the cerebro-spinal nerves, or through stim- 
ulation of the sympathetic system. 

To reduce the temperature by heat radiation,, 
the operator holds the vaso-motor nerves in the 
neck, thereby causing the blood vessels of the body 
to dilate, and so bleed the body into itself. Taking 
the blood to the periphera, from the engorged cen- 
tres, the sweat glands are brought into action. The 
vaporization of the sweat cools the skin and also 
the entire body. All physicians look upon a high 
internal temperature as dangerous, but as soon as 
they start a gentle sweat the prognosis is good, un- 
less complications arise. 



30 MANUAL OF OSTEOPATHIC THERAPEUTICS. 

To lower temperature by heat dissipation, hydro- 
therapy may be called into use. The cold bath is 
the method par excellent, using the Brandt method. 
Care should be taken, however, not to chill the pa- 
tient to the extent that he does not react from the 
first shock. When he is lowered into the cold 
water, the blood first rushes from the periphera to 
the center, then rebounds to the surface with re- 
newed vigor. The nurse should keep up a brisk 
rubbing all the while he is in the bath. When 
taken out of the bath, and wrapped in a blanket, 
there is a pink glow to the skin, showing a good 
circulation ; soon a gentle sweat starts, and the pa- 
tient drops off to sleep. 

Antiarthritics. 

A treatment given for the relief of inflammations 
occuring in joints is termed an antiarthritic. A 
treatment given to prevent the progress of inflam- 
matory processes is termed an antiphlogistic, this 
one cardinal fact is to be remembered, it is an im- 
possibility for a perfect circulation and inflammation 
to exist in the same place, at the same time. In in- 
flammation there is an engorgement of the blood 
vessels and the circulation is sluggish. The treat- 



MANUAL OF OSTEOPATHIC THERAPEUTICS. 31 

ment directty over the inflammatory area should be 
light but the muscles and tissues of the contingent 
structures may be thoroughly treated causing the 
arterial blood to flow freely through the tissues and 
the venous blood to freely drain them. Dry heat 
is a remedial measure that is at the present time 
attracting attention, especially as an antiarthritic. 

Antispasmotics. 

A treatment given for the relief of spasm is 
termed an antispasmotic. The spasm may be the 
periodical spasm of epilepsy or the acute spasm of 
some acute disease. The treatment depends greatly 
upon the nature of the disease, but as a rule an at- 
tempt should be made to relax the patient. In the 
acute spasm as for example — colic, inhibit the nerves 
of the lower dorsal region thereby inhibiting the 
peristaltic action of the intestines through the in- 
hibitation of the splanchnic, and also lessening the 
pain. Of course the irritating substance must be 
removed or else the pains will return. 

In hiccough the treatment is to inhibit the 
phrenic by pressing against it in the neck, fixed 
expansion of the chest by holding the costal carti- 
lages of the ribs just below the xyphoid cartilage 



32 MANUAL OF OSTEOPATHIC THERAPEUTICS. 

also acts as an antispasmotic by preventing the 
spasmotic contractions of the diaphram. 

In epilepsy there is a chronic morbid condition 
to deal with and the majority of cases have some 
pathological lesion in the generative organs. If 
no lesion is found here then the cervical vertebra 
are apt to be out of line. Wherever the lesion i& 
found treatment must be given for its correction. 
An old housewife remedy for acute spasm is ta 
place the patient in a hot bath, the warm water re- 
laxing the entire body. 

Bitters or Gastric Stimulants. 

A treatment given to stimulate the gastrointes- 
tinal mucus membrane without effecting the general 
system is termed a gastric stimulant. The medical 
doctor gives a bitter drug, as for example — quassia,, 
that acts by its bitterness alone, the bitter stimu- 
lates the glands into action. The osteopath, by his 
manipulation over the siomach, excites an increased 
flow of blood to the stomach and thus tones up the 
walls of the stomach, causing the glands to secrete 
freely. A bitter is used in cases in which the food 
does not assimulate but remains for the greater 
part of it in the alimentary canal unchanged, feeling; 



MANUAL OF OSTEOPATHIC THERAPEUTICS. 33 

like a heavy weight in the pit of the stomach, or 
else fermentation takes place and the patient bloats. 
An old German remedy is prescribed by some phy- 
sicians ; each morning before arising roll a heavy 
cannon ball over the abdomen, this not only stimu- 
lates a flow from the mucous membrane but excites 
a peristalsis of the intestine and a desire for stool. 
This movement is given generally in combination 
with several other movements in a prescription 
treatment. 

A patient presenting himself for pain in the head 
or some other part of the body not regarding a 
slight indigestion as sufficient cause to consult a 
physician. In some cases he has put off seeking 
relief for so long that the case is very obstinate and 
will only yield to several months treatment. Care 
must be used in diagnosing, to differentiate a sim- 
ple lack of tonicity of the gastric wall, from gastric 
ulcer, gastric cancer, etc. 



34 



MANUAL OF OSTEOPATHIC THERAPEUTICS. 



Accelerator 

nerves of 

heart. 



Inhibitory 

nerves of 

heart. 



Cardiac Nerves. 

From acceler. cent, of med. obi. fibers pass 
through lateral tract of cord to inf. cerv. 
gang and first dorsal ganglia, thence to 
intra cardiac accel. centre. 

From acceler. cent, of med. obi. through 
vagus to intra cardiac accel. centre. 

From vaso-inhib. centre of med. obi. through 
vagus to intra cardiac inhib. centre. 

From cardio-inhib. fibers of vagus from ex- 
tra cord inhib. centre of med. obi. 

From va?o-motor nerves to arteries and 
veins. 



Cardia motor ( Fibers from intra cardiac accelerator centre, 
center of j 
heart. ( Fibers from intra cardiac inhibitory centre. 



Cardiac Stimulants. 

A treatment given to increase the heart action 
is a cardiac stimulant. This is a treatment that the 
greatest of care must be used in prescribing. If a 
patient presents himself, whom upon examining, a 
cardiac murmur is detected and the heart is com- 
pensating for the valvular difficulty it would be 
criminal to give him a cardiac stimulant for you 
would cause the heart to become irregular in its 



MANUAL OF OSTEOPATHIC THERAPEUTICS. 35 

rhythm and a rupture of the compensation would be 
very liable to take place, but if the heart is weak 
in its action the patient complains of his legs and 
arms going to sleep, he looks pale and a general in- 
dication of poor circulation, then a stimulant to 
whip the heart into action is required. The heart 
rhythm is governed by the sympathetic system, most 
physiologists agreeing that there are three ganglia 
that control this rhythm. The inferior cervical gan- 
glia is situated low down in the neck and is con- 
nected to the sixth and seventh cervicle and first 
dorsal nerves by rami communicantes, it also has 
a few fibres from the pneumogastric. It sends 
branches to the inferior cardiac ganglion which act 
as accelorator to the heart. By stimulation then 
of the nerves of the lower portion of the neck, the 
heart will beat stronger fuller and quicker. The 
fibres from the pneumogastric will cause the heart 
to pause just long enough, before each contraction, 
for the ventricles to be filled and then when con- 
traction takes place a full pulse wave is sent forth. 
By this double action we quiet a wild fluttering 
heart ; one that when the ear is placed to the chest, 
sounds like a bird fluttering in a cage, and a feeble 
acting heart sending out a small watery pulse ; the 
beat becomes regular, full and strong. 



36 manual of osteopathic therapeutics. 

Cardiac Depressant. 

When called in to see a patient with a heart 
beating very rapidly, and sending out a full pulse 
wave at each beat, a treatment to lessen the heart 
action is required. Stimulation of the pneumo- 
gastric, or the superior cervical ganglia, acts as a 
cardiac depressant. The fibers from these nerves 
pass to the superior cervical ganglia. 

Owing to the fact that the inhibitory nerves of 
the heart are constantly at work, they have a greater 
area of distribution. The accelorator nerves are 
only called into action in an emergency. The pas- 
sage of the blood over the endothelial lining of the 
heart sends a reflex stimulus to the central ganglia, 
and so causes each cardiac cycle. 

Many patients present themselves for treatment 
with heart trouble. Their family physician has 
discovered a murmur, and, consequently, begins 
giving digitalis, cactus, or some other heart stimu- 
lant. As a consequence, when you find the patient 
he has a large, irregular heart, the pulse rapid, full 
and strong. The face is flushed, and he may com- 
plain of headaches. The first thing is to stop the 
drug. The next is, put the patient to bed ; make 
him take absolute rest. Then the osteopathic treat- 
ment consists in depression of the vaso-motor cen- 



MANUAL OF OSTEOPATHIC THERAPEUTICS. 37 

tres, in the region of the first, second and third 
thoracic vertebrse, and holding the vaso-motor cen- 
tre high in the neck, thereby dilating the blood- 
vessels of the body, and so take much of the work 
off of the heart. Stimulation of the pneumo-gas- 
tric can be made in the triangle of election. This 
treatment, given from one to four times a day, com- 
bined with the absolute rest, will prove beneficial 
to any case similar to the one described above. 

Cathartics. 

A treatment given to produce an ordinary pas- 
sage of feces is called a cathartic. 

When the bowels are blocked by intussuscep- 
tion, bands of adhesion from old cases of inflam- 
mation of the peritoneum, etc., of course more 
rigid measures are to be taken, and in some cases 
surgical operations must be resorted to. The ordi- 
nary case of constipation is due to one of two 
causes : (1) lack of secretion of mucous; (2) want 
of parastalsis. These two functions are governed 
by Auerbactts plexus, which distributes filaments to 
the muscular layer of the entire intestinal canal. 
From this plexus numerous branches perforate the 
internal circular muscular layer and unite to form 



38 MANUAL OF OSTEOPATHIC THERAPEUTICS. 

a gangliated plexus, called Meissner's plexus, in 
the sub-mucous tissue. Auerbach's plexus sup- 
plies the muscular coat and regulates the peristaltic 
action of the bowel. Meissner's plexus determines 
the calibre of the blood vessels, and, consequently, 
the secretion of mucous. These plexuses are off of 
the superior and inferior mesenteric plexus, which 
is a division of the coelic plexus. 

The great splanchnic I have found to have a 
double action. In some cases treated, constipation 
always followed a heavy treatment of the dorsal 
region, and, again, a light treatment caused a desire 
for stool in a short while after treatmeut. A thor- 
ough treatment over the abdomen, though, stimu- 
lates a flow of mucous and excites peristalsis. Bile 
excites peristalsis and secretion of mucous, but 
that is considered under the head of cholagogues. 

When there is a lack of mucous, the feces be- 
comes hard and the intestinal wall loses its moist- 
ure. If there is peristalsis, the movement of the 
hardened feces causes inflammation. As a conse- 
quence, the bowel is practically put in a splint. 

A treatment given for the expulsion of gas is 
termed a carminative. The treatment is practically 
the same as that given for constipation. The gas 



MANUAL OF OSTEOPATHIC THERAPEUTICS. 39 

is passed along by the peristaltic action of the in- 
testine. 

The cause of the formation of the gas is an en- 
tirely different matter, and must be looked into. It 
may be due to lack of bile, or some other intestinal 
juice. An old housewife remedy for the relief of 
wind colic in babies is to pass a flexible rubber 
catheter up into the rectum. 

An ordinary desire for stool is due to the exci- 
tation of the ano-spinal centre, situated in the lum- 
bar region of the cord ; the affarent fibers being 
from the hemorrhoidal and inferior mesenteric 
nerves ; the efferent, the pudendal plexus. The dis- 
tention of the walls of the rectum, causing the re- 
flex to take place. In babies, mothers often slip a 
soap plug up into the rectum. The soap is an irri- 
tant and excites peristalsis. 

Cholagogues. 

A treatment given for the stimulation of the flow 
or bile, is termed a cholagogue. The bile is nature's 
cathartic and antiseptic, on account of its bitterness 
it stimulates the intestional glands into action, 
causing a free flow of mucous and also excites per- 
istalsis. Where there is a healthy flow of bile, the 



40 MANUAL OF OSTEOPATHIC THERAPEUTICS. 

food does not ferment and form gas in the intes- 
tines. It also dissolves and emulsifies fats, thereby 
facilitating its absorbtion. This then explains the 
fatty diarrhoea in cases of liver diseases where the 
flow of bile is obstructed. It has been proven by 
experiment that membranes when moistened with 
bile greatly facilitate the passage through them of 
fat. It has also been proven by experiment that if 
the bile is diverted from the alimentary canal by a 
biliary fistula, the animal sooner or later dies. 

The nerves of the liver are derived from the left 
pneumogastric and cceliac plexus. Whenever food 
enters the intestine and a secretion of bile takes 
place, there is a peristaltic wave passes throughout 
the liver. 

Many women suffer from constipation and also 
have a diseased condition of the uterus. This in- 
flamed uterus is constantly sending forth impulse 
along the sympathetic system, owing to its very ex- 
tensive connection with it. These impulses cause 
a movement in the liver, nature responds to the calls 
for a while but soon gets tired and then the liver 
becomes torpid and congested, it does not respond 
to food entering the intestine and the woman com- 
plains of stomach trouble, constipation, etc. This 
diseased uterus is also the cause of cardiac irregular- 



MANUAL OF OSTEOPATHIC THERAPEUTICS. 41 

ities or any other organ connected to it through the 
sympathetic. If upon examining the patient and 
a diseased uterus is found, it must be cured to ob- 
tain good results with the liver. The stimulation 
of the liver under the edge of the ribs excites peris- 
talsis in the organ and bile is ejaculated from the 
bile duct into the intestine ; an increased flow of 
blood is caused also, by the treatment and as a 
slight congestion is physiological during digestion. 
This increased flow of blood assists greatly in the 
production of the bile. A decided congestion of 
the liver though, is equally as pathological as an 
ansemic condition, for then the congested vessels 
press against the biliary ducts preventing the bile 
from flowing freely. 

Diaphoretics. 

The secretion of sweat like other secretions is 
influenced by the nervous system the sweat centres 
being situated in the anterior horns of the gray 
matter of the spinal cord and medulla. From 
these centres nerve fibres arise, which passing down 
the cord emerge principally with the anterior roots 
of the third, fourth and fifth cervical nerves to pass 
with the brachical plexus to the skin of the upper 



42 MANUAL OF OSTEOPATHIC THERAPEUTICS. 

extremity and with the anterior roots of ihe lumbar 
nerves to supply the lower extremity. The sweat 
centres may be stimulated by a reflex action and 
inhibited by cold. A treatment given for the stim- 
ulation of the flow of sweat, is termed a diaphoretic : 
and one given for the preventing of sweating an 

The skin is one of the important organs of the 
body and should be kept as clean on the body as 
that covering the face and hands. The old Romans 
knew the importance of the bath and the poorest 
were not deprived of it. The skin may act as a 
source of nourishment to the body, as well as aid 
in throwing on the impurities. Sailors shipwrecked 
in mid- ocean without fresh water find relief from 
the thirst by immersion of the body in the sea : and 
in certain cases where the introduction of food by 
the mouth is impracticable immersion of the patient 
in a bath of tepid milk morning and evening main- 
tains life. 

Diuretics. 

If the flow of urine be stopped in man he will 
soon die from uremic coma, but the amount of 
urine passed in a day varies to a very great extent. 
If a man is working in the sun drinking large quan- 



MANUAL OF OSTEOPATHIC THERAPEUTICS. 43 

tities of water, he sweats freely and the urine is less, 
but if he sweats freely and no more water than 
usual is drunk the urine becomes scanty and highly 
colored showing concentration. A person on a 
severe nervous strain passes water very frequently 
showing there is a very extensive connection with 
the sympathetic system. The amount of urine passed 
depends upon the amount of blood in the kidney and 
therefore the secretion of urine is influenced by the 
vaso-motor nerves. This can be readily demonstrated 
by means of the oconometer and oncograph, by 
which the volume of the kidney in the living animal 
can be shown to vary with the blood circulating 
through it; the amount of the latter being regulated 
by the vasomotor nerves. It has also been demon- 
strated that to puncture the fovea situated on floor 
of fourth ventricle of brain causes an increased flow 
of urine. In some cases the amount passed in a day 
is enormous. Then therefore it is proven the so- 
called kidney diseases are only symptoms — the real 
disease is situated in the nervous system, or where 
new tissue formation has taken place in the venous 
or arterial system. In the treatment the vaso motor 
nerves are acted upon to cause dilatation or con- 
traction of the blood vessels, as the inferior fovea is 
situated very close to the vaso motor centre in the 



44 MANUAL OF OSTEOPATHIC THERAPEUTICS. 

medulla oblongata, there is in all probability a very- 
close connection of these two centres. The vaso 
motor nerves are found throughout the cord there- 
fore the principal point of stimulation is in the 
lumbar and inferior dorsal region. The kidney may 
be palpated anteriorly in some people and be stimu- 
lated directly. 

All osteopaths should understand urinalysis 
thoroughly. If a case of kidney trouble presents 
itself an examination of the urine will tell the story 
complete and also tell if the case is a curable one. 
No one would think of attempting to cure a badly 
degenerated waxy or fatty kidney ; he could only 
paliate the symptoms. 

Emetics. 

A treatment given to produce vomiting is termed 
an emetic. As a rule, an emetic is an emergency 
treatment, as, for example, in the case of poisoning. 

As far as I have been able to learn, a successful, 
quick-acting osteopathic emetic treatment has not 
been discovered ; but a firm pressure upon the epi- 
gastric region, especially if the fingers are placed 
about on the junction of the umbilical and epigas- 
tric region, and pressure made upward and back- 



MANUAL OF OSTEOPATHIC THERAPEUTICS. 45 

ward, excites the solar plexus, and regurgitation 
takes place. For this reason, a patient must not be 
treated over the abdomen directly after eating. 
Patients have been known to faint or become very 
sick when treated on a full stomach. 

This treatment is very successful, however, in 
cases of indigestion, where the presence of food 
causes great distress. The food is forced out of the 
stomach, and then the special treatment may be 
given for the cure of the diseased condition. 

Emmenagogues. 

A treatment given for the stimulation of the 
menstrual flow is termed an emmenagogue. 

The physician must use the greatest precaution, 
or he will be imposed upon and commit an abor- 
tion. In some cases, however, the woman com- 
plains of a stoppage of the menstrual flow and is 
innocent of the fact that she is pregnant. 

Stoppage of the menstrual flow is due, gener- 
ally, to taking cold during or just prior to the men- 
strual flow, and is to be differentiated from amenor- 
rhea, which is a condition when the stoppage is 
continued over a considerable period of time, or 
has never started. Just prior to menstruation, 
there is a physiological hyperemia of the uterus. 



46 MANUAL OF OSTEOPATHIC THERAPEUTICS. 

The hemorrhage results from the hyperemia 
being so great that, according to some, rupture of 
the capillaries of the mucous membrane of the cav- 
ity of the body occurs. 

The capillary tension immediately preceding the 
rupture of these vessels is explained by contrac- 
tion of the muscular fasciculi, including the vessels 
of supply and return, this contraction affecting the 
veins more than the arteries, in consequence of the 
thin walls of the former, and by contraction of the 
muscular rings surrounding the large uterine veins. 

The treatment is to cause a flow of blood to the 
pelvic region, and contraction of the muscle fibers. 
To increase the flow of blood to the pelvis, forcible 
adduction of the thigh, with the patient in the dor- 
sal position. Also, direct the patient to contract 
the perineum, as in restraining a movement of the 
bowels. To lie on the back and rise to a sitting 
posture causes contraction of both the abdominal 
and perineal muscle?. Stimulation is to be made 
in the lumbar region to cause contraction of the 
muscular fibers. 

An old remedy for suppressed menstruation is 
to have the patient take a hot bath, or a hot foot 
bath, drink warm drinks, and go to bed, the object 
being to cause a flow of blood to the pelvis. The 



MANUAL OF OSTEOPATHIC THERAPEUTICS. 47 

heat causes the capillaries to dilate, and thus cause 
the hyperemia necessary. 

Hypnotics. 

Acting upon the theory of the causation of sleep 
as advanced by Dr. Cappie, the osteopath presents 
the best possible simple hypnotic, that is, when 
the patient is not suffering from pain. Dr. Cappie 
holds that the molecular activity of the cerebral 
cells is diminished through less blood being sup- 
plied to them by the capillaries, and that, conse- 
quently, the brain occupies less space. But, inas- 
much as the brain case must be full, the veins of 
the pia mater become proportionately distended, 
the effect of which is, that although the absolute 
quantity of blood, and, consequently, the pressure, 
remains the same, the direction of pressure is mod- 
ified, being less from within and more on the sur- 
face of the brain. The latter, or the alterating di- 
rection of the pressure gives rise to sleep. 

When pressure is made upon the common car- 
otid, by the osteopathic operator, he must, of a ne- 
cessity, also make equal pressure upon the internal 
jugular vein, and thereby bring about the condition 
in the brain described in the above theory. 



48 MANUAL OF OSTEOPATHIC THERAPEUTICS. 

This theory is also supported by Dr. Durham,, 
in Guy's Hospital Reports, 3d series, vol. vi, and 
Dr. Hughlings Jackson, in the Royal London Oph- 
thalmalogical Hospital Reports. 

Very frequently in high fevers, the patient lies 
awake for hours, but upon the operator giving him 
a treatment he goes to sleep. This is because the 
operator has depressed the vaso-motor centre, and 
so bleeds the patient into his own body, taking the 
blood out of the congested brain. 

Mydriatics. 

A treatment given to produce a dilatation of the 
pupil is termed a mydriatic. 

The cilio-spinal centre is situated at the origin 
of the first and second dorsal region, the nerves 
passing into the sympathetic. 

The nerves of the iris are the long ciliary given 
off from the nasal branch of the opthalmic divis- 
ion of the fifth, and the short ciliary derived from 
the ciliary ganglion. The fibers derived from the 
motor root of the ciliary ganglion supply the cir- 
cular fibers, while those derived from the sympa- 
thetic supply the radiating fibers of the iris. 



MANUAL OF OSTEOPATHIC THERAPEUTICS. 49 

By the experiment of cutting the third nerve,, 
and the pupil dilating, and the cutting of the sym- 
pathetic, the pupil contracting, they have deter- 
mined the power each exercises upon the iris. 

The iris is a shutter in the eye, admitting just 
the amount of light necessary. In some cases, 
though, as in cataract, the iris must be dilated, and 
in these cases, theoretically, stimulation of the first 
and second nerves would produce a dilation of the 
pupil. 

Nervous Stimulants. 

A treatment for the general stimulation of the 
nerves is indicated in any case of nervous depres- 
sion or lack of tonicity in the body. Probably the 
best general nervous stimulant is extension of the 
spine. The spinal cord being part of the central 
nervous system traction made upon it causes a 
general excitement of the nervous system. This 
stretching may be made in several ways — the more 
common way is for one operator to stand at the 
head and one at the feet and then both pull. The 
traction should be made very gradually and when 
letting up do so gradually, not suddenly. Patients 
complain very bitterly of sudden relaxation after 
extension, they say the pain is sharp and stabbing 



50 MANUAL OF OSTEOPATHIC THERAPEUTICS. 

in character. I would recommend that all osteo- 
paths have a jury mast, in their operating room, by 
means of this they can extend the spine gradually; 
keep the patient in the position as long as necessary 
and then let him down gradually. 

A nerve depressant is a treatment to quiet an 
over-excited condition and consists in inhibiting 
the nerves along the entire length of the vertebra?, 
and I have found that there is a massage movement 
that is very successful. Grasp the muscles of the 
arm, twist around as far as possible, and then push 
up and jerk down; do the same with the forearm, 
thigh and leg. This combination will generally 
quiet a very nervous patient. 

Toxics. 

A tonic is a general treatment to act as a general 
stimulant to the entire system. An operator can 
give a perfectly healthy, robust person a heavy 
treatment and he will get off of the operating table 
a tired man; or else he can give a light treatment 
to a tired person and he will feel refreshed when he 
gets off of the table, therefore the light treatment is 
the tonic treatment and is to be given to convales- 
cents and people who complain of lacitudes. Those 



MANUAL OF OSTEOPATHIC THERAPEUTICS. 51 

who are not really sick but need something to brace 
them up, or else a tonic may be given when there 
is a general run down condition of the system, as in 
a man broken down by business cares, or a woman 
who has not been able to stand the demands of 
society. The tonic treatments may be given every 
day or every other day just as the case demands. 

Uterine Tonic. 

In some conditions, as, for exampls, amenorrhea, 
or lack of menstruation, Menorrhagia, or the loss of 
an abnormally large amount of menstrual fluid, 
and metrorrhagia, or the passage of blood from the 
uterus, either at or between the times for the men- 
ses, a tonic treatment must be given the uterus. 

These diseases may be due to a very large num- 
ber of conditions, endometretis being the principal 
one. Endometretis is an inflammation of the lin- 
ing membrane of the uterus. This may be due to 
a dislocation of the uterus, constipation, etc., caus- 
ing a congestion of the pelvic veins, or it may be 
due to septic or infectious processes. Whatever is 
the cause, if due to dislocation of the uterus, it 
must first be replaced and then the inflammation 
treated. The establishment of a perfect circulation 
will obliterate the inflammation. 



52 MANUAL OF OSTEOPATHIC THERAPEUTICS. 

To increase the flow of blood to the pelvis, all 
forms of active exercise may be used, particularly 
the flexing and extending of the body while in a 
standing position. 

To diminish the flow to the pelvic organs, con- 
traction of the muscles of the back and the abduct- 
ors of the thigh are principally employed. 

Understanding these two principles, the operator 
can regulate the amount of blood to the uterus. 

Amenorrhoea may be congenital. That is, the 
flow has never been established. In such cases, the 
uterus may be undeveloped, and it must be stimu- 
lated into growth and activity. Stimulation of the 
clitoris has been found to be an elegant treatment 
for barrenness. It causes an erection of the uterus 
by the increased blood supplied, and as barrenness 
is usually due to an endometretis,the stimulation of 
the clitoris is also a cure for simple endometretis. 

Pulling of the hair over the pubes also acts as a 
stimulant, as it excites the cutaneous nerves, and, 
through them, the deeper structures. 

In neuralgiac dysmenorrhoea, a tonic treatment 
at the menstrual period, and between the attacks, 
will oftentimes effect a cure, but, as a rule, the 
treatment is directed more to the general system 
than the uterus, in this disease. 



manual of osteopathic therapeutics. 53 

Vaso-Motor Stimulants. 

In the treatment of fever the vaso-motor nerves 
are the ones the osteopath anchors to, placing the 
major portion of his hope of success on the action 
of them. In a fever the pulse is high and beady, 
the object is to slow the heart and get a full pulse 
wave. The vaso-motor nerves of the head are ap- 
parently derived from the superior cervical glanglia 
but they can be traced by their division and elec- 
trical stimulation through the cervical cord of the 
sympathetic to the anterior roots of the first three 
dorsal spinal nerves, and thence into the anterior 
columns of the cord. 

The vaso-motor nerves supplying the blood ves- 
sels of the upper extremity take their origin in the 
spinal cord, passing off with the anterior roots of 
the third, fourth, fifth, sixth and seventh dorsal 
nerves, and then passing into the thoracic portion 
of the sympathetic. Some of the vaso-motor nerves 
of the brachial plexus are derived from the anterior 
roots of the spinal nerves. The splanchnic nerves 
are derived from the lower part of the dorsal region 
of the cord and distributes vaso-motor nerves to the 
blood vessels of the abdomen, with the lumbar and 
sacral plexus vaso-motor nerves pass out and are 
distributed to the lower extremities. The common 



54 MANUAL OF OSTEOPATHIC THERAPEUTICS. 

centre for the vaso- motor nerves has been located 
in the medulla oblongata on the floor of the fourth 
ventricle, Justin front of the calamus scriptorius. 
Stimulation of this centre sends out a general order 
for all blood vessels to contract. There is a gentle 
impulse being sent out from this centre all the 
time during health, to maintain the normal calibre 
of the blood vessels. On account of the fact that 
the vaso-motor nerves are distributed along the 
cord they may be stimulated reflexly at any point 
along the cord. 

Holding of the vaso-motor nerve acts as a vaso- 
motor depressant. When the vaso-motor nerves are 
cut off from action the blood vessels will of a 
necessity dialate to their fullest capacity, the vascu- 
lar tonus is relieved. The pressure of the blood 
from within overcomes the action of the circular 
muscles of the blood vessels. In fever the blood 
vessels are contracted and the heart has hard work 
forcing the blood through the constricted passage 
ways and as a consequence the greater part of the 
blood is confined to the deeper structures causing a 
congestion of them, or else the heart is pumping 
too fast, and too great a quantity of blood is being 
sent to the brain causing coma or delerium. When 
the vaso-motors are depressed the blood vessels 



MANUAL OF OSTEOPATHIC THERAPEUTICS. 55- 

dialate, taking the blood from the congested cen- 
tres to the capillaries of the periphera ; this flood of 
blood to the skin causes the sweat to start and the 
evaporation of it cools the body. It is a bleeding 
of the body into its self. 

The dilatation of the blood vessels also has a 
decidedly beneficial action on the over-acting heart. 
It is certainly easier to pump blood into a large 
blood vessel than a constricted one, therefore the 
strain is taken off of the heart and it settles down 
into a regularity, taking more time for each beat as 
it requires more blood to fill the dialated blood 
vessel. As a consequence we have a gentle perspir- 
atian started, the blood taken from the congested 
centres, and a full pulse wave. Stimulation of the 
vaso-motors would be made in just the opposite 
conditions, where there was lack of vascular tonus, 
the patient complaining of cold etc. 

Some authorities describe a vaso-dialator nerve 
acting against the vaso-motor or vaso constrictor 
nerves, but this has not been demonstrated as con- 
sisting of a definate system over the body. 



56 MANUAL OF OSTEOPATHIC THERAPEUTICS. 

I have reprinted two of my articles ; one, "Loco- 
motor Ataxia," from the Boston Osteopath, Vol. I, 
No. 4; and "The Coccygeal Gland," from the Nor- 
thern Osteopath, Vol. II, No. 8. I believe these arti- 
cles are of importance to osteopaths. 

Locomotor Ataxia. 

In the discussion of this disease from an osteo- 
pathic standpoint, we must take into consideration 
that it is a disease pronounced incurable hy the 
medical fraternity, because there has been a degen- 
erative change in the nerves, forming the spinal 
cord, and nature can not rebuild this lost tissue. 
It is true they have failed to cure the disease, but 
numerous cases are on record that have been cured 
by osteopathy. 

In the research for cause, there is found a history 
of exposure to cold and damp, excessive fatigue, 
sexual excess, in fact a succession of shocks or 
strains on the nervous system. It is found more 
frequently in men than in women. 

Upon examination of the spinal cord, a degen- 
erative change has taken place in the posterior or 
sensory portion of the cord, and hence the theory 
that the disease originates in the cord. But it does 
not originate there. "The lesions of the spinal 



MANUAL OF OSTEOPATHIC THERAPEUTICS. 57 

€ord in tabes occur by segments, each posterior 
root bringing into the posterior column a fresh con- 
tingent of degenerated fibers" (Osier). 

From this we see that the origin is external to 
the cord and is primarily in the peripheral nerve 
trunks, or the degenerative process ascends to the 
cord, and this degeneration is started by the injury 
to the peripheral nerve trunks or ganglia. 

It has been clearly demonstrated, in surgery, 
that a nerve may be cut and new tissue will form 
between the cut ends, and the function of the nerve 
may be re-established by the use of continued elec- 
tric stimulation. 

Now, why can not nature re-establish the func- 
tion of a degenerated segment of a nerve, if the 
cause of such degeneration is removed, and the 
nerve is revived into action, and the growth of 
healthy tissue be stimulated around the nerve? It 
<3an be done if the case is taken in time, say in the 
pre-ataxic stage or the ataxic stage. In the para- 
lytic stage, the lesion has extended over a large 
area of the cord, but still this method of treatment 
is the most rational, and has cured some cases in 
this stage. 

Attempts to stimulate the healthy action of the 
nerves are observed in suspension treatment, advo- 



58 MANUAL OF OSTEOPATHIC THERAPEUTICS. 

cated by some of the European physicians. Chip- 
ault and De la Tourette published a book entitled, 
"True Elongation of the Spinal Cord and its Ap- 
plication to Locomotor Ataxia." Their methods 
show some good results, but they begin at the 
wrong end of the line for treatment. As I have ob- 
served the cases treated in the Pacific School and 
Infirmary of Osteopathy, they not only receive ex- 
tension of the spine, but stimulation of all the per- 
ipheral nerves in the locality from which the origin 
of the tabes occur, as well as stretching and mov- 
ing all the muscles of the back, to strengthen them, 
for in cases of the second stage it will be noticed 
that these muscles have become soft and useless. 

Upon this plan of treatment, cases of the pre- 
ataxic and ataxic stage will receive decided benefi- 
cial results, and in many cases a complete recovery 
is the result. 



manual of osteopathic therapeutics. 59 

Coccygeal Gland. 

Dislocations of the vertebra in the cervical, tho- 
racic and lumbar regions, and the nerves involved 
by such dislocations, are very familiar subjects to 
osteopaths. They always have a care to look par- 
ticularly for tender spots along the spine, then feel 
carefully for dislocations. In some cases they can- 
not find one and the fertile, imaginative brain be- 
gins its work. " Surely," they say, "how can we 
have such an exquisitely tender spot without a dis- 
location to expose the nerve," and so they find one 
"in their brain." 

It is strange that osteopaths, who have been 
drilled on anatomy more thoroughly than any 
other single branch, should forget or overlook the 
fact that the coccyx is a part of the vertebral col- 
umn, and that fifty per cent of the people have dis- 
located coccyx, due, in some cases, to sitting too 
much on the back. One who sits down in a rock- 
ing chair, far forward in the seat, then leans back 
and rocks, sits more upon the sacrum than upon 
the ischium, and thereby shoves the coccyx for- 
ward. This is one of the reasons one finds a for- 
ward dislocation of the coccyx in women, so often. 
Men who are engaged in office work suffer the same 
habit. 



60 MANUAL OF OSTEOPATHIC THERAPEUTICS. . 

Now, this small bit of bone does not amount to 
much, it seems, but it is of the greatest of import- 
ance. Dislocation of this bone may cause innum- 
erable diseases, and, what is more, may cause death. 

One case which came under my observation, in 
consultation with W. J. Hay den, at Redlands, Cal. : 
A woman was confined to her bed, unable to move 
her head, and the hands and feet but slightly. 
Along the spine at no point could she bear the 
weight of the hand. Very evident that something 
was decidedly wrong. There was no dislocation of 
the vertebra in the cervical, thoracic or lumbar re- 
gions, but the coccyx was turned in, and at right 
angles with the sacrum, and twisted. There was 
the trouble. She gave a history of a fall, and in- 
validism ever since. Under osteopathic treatment 
she was deriving great benefit the last I heard of 
her. 

Quoting a case recorded in Stinison's "Treatise 
on Dislocations, " in chapter on Dislocations of the 
Coccyx, page 396, "the patient, a large, corpulent 
woman, thirty-six years old, fell astride the back of 
a chair. She at once suffered severe pain in the 
coccygeal region, much aggravated by attempts to 
sit, but she was able to go about for some hours. 
At last the pain became so severe that she took to 



MANUAL OF OSTEOPATHIC THERAPEUTICS. 61 

her bed, when she found she could neither move or 
turn. When seen, the next day, there was so much 
immobility and stiffness of the body as to suggest 
tetanus. Besides the severe pain in the coccygeal 
region, she complained of a painful, tense, dragging 
sensation, extending up toward the nape, and along 
the arms to fingers, which felt numb. She could 
not bear to make the slightest movement. The 
head was confused, and the intellect somewhat 
clouded, No unnatural sensation in lower limbs. 
Urine and feces were passed naturally. 

A small swelling was felt on the left side of the 
fissure of the buttocks which proved to be the 
coccyx torn away from the sacrum, and carried to- 
ward the left ischium. The end of the sacrum from 
which it had been displaced could be plainly felt. 
Finger in the rectum showed the exact nature of the 
displacement still better, and when firm pressure 
was made downward and to the right against the 
displaced bone, it suddenly resumed its normal 
position. The patient declared she immediately 
felt quite another being, the confusion of the head 
and painful sensation along the spine and arms dis- 
appearing. At the end of the fifth day no incon- 
venience beyond a slight burning pain near the 
sacrum remained." In some dislocations forward 



62 MANUAL OF OSTEOPATHIC THERAPEUTICS. 

there will be pain down the thighs as well as the 
other symptoms. 

Why all this nervous trouble? There is as much 
as there would be in many lesions of the brain. 
Luschka, in the British Medical Journal, June 13, 
1874, described a small gland situated between the 
levatores ani and the sphincter ani near the top of 
the coccyx. It is composed of a plexus of small 
arteries and veins which are surrounded by layers 
of granular polygonal cells. The body is invested 
by connective tissue and has branches from the 
ganglion impar of the sympathetic system and fila- 
ments from the coccygeal nerves of the cerebro- 
spinal system. No use for this ganglia has ever 
been determined. Some authors class it as an ar- 
terial plexus, some do not even mention it, all treat 
it as of no consequence. Does it seem reasonable 
that nature would place a gland of such intricate 
makeup in the human body without a function? 
Certainly, to my mind, the extreme prostration and 
hyperesthesia of the spine, in some dislocations of 
the coccyx, are due to the pressure or disturbance of 
this gland. Any pressure as from a full rectum 
causes a stimulation and vibration of the granular 
bodies, causing the generation of nerve force and an 
impulse is sent to the brain. If this pressure is in- 



MANUAL OF OSTEOPATHIC THERAPEUTICS. 63 

creased or the stimulation is continued at great 
length there is such a generation of nerve force that 
the nerve cannot carry it and paralysis sets in, or 
the nerves become sore and tender to the touch 
from inflammation. 

This I hope will cause osteopaths to look other 
than in the cervical, thoracic or lumbar regions for 
the cause of the hypesthetic points. 




■HI 



